Ain shams University, Cairo, Egypt.
Aesthetic Plast Surg. 2021 Oct;45(5):2233-2241. doi: 10.1007/s00266-021-02138-1. Epub 2021 Feb 12.
Brachioplasty of deflated arms following massive weight loss (MWL) often results in too slim arms. These slimmer arms lack the natural proportion and contour. This study presents a novel method for such arms through standard skin excision and autoaugmentation by dermofat flap.
During a period of 2 years, 21 women complaining of severe deflation deformity of upper arms following MWL were operated. At time of surgery, the BMI ranged from 20.5 to 33. 4 with a mean of 26.2 kg/m. The mean value of weight loss was 47.8 kg over a mean period of 18 months.
A de-epithelialized dermofat flap was preserved underneath the dissected and advanced anterior and posterior arm skin flaps. The bulk of the flap was tailored as to give an appropriate girth with balanced proportion and contour of the upper arm.
During 14 months of follow-up, all patients reported a high satisfaction. Objective evaluation was based on measurement of the mid-upper arm circumferences (MUAC) and its ratio with the mid-forearm circumferences (MFAC) which was compared with those of arms of healthy volunteers with normal BMIs.
Augmentation of the upper arm by autologous dermofat flap provides a well arm contour in appropriate balance with the forearm in women having severe arm deflation deformity following MWL. The findings were supported by the objective anthropometric measurements of the MUAC/MFAC of a normal weight healthy women which reached to a mean value of 1.366. The normal girth of upper arm should equal 1[Formula: see text] that of the forearm.
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
大量体重减轻（MWL）后瘪臂的臂成形术常导致手臂过于纤细。这些更细的手臂缺乏自然的比例和轮廓。本研究通过标准皮肤切除和真皮脂肪瓣的自体增强为这些手臂提供了一种新的方法。
在 2 年期间，对 21 名抱怨 MWL 后上臂严重瘪陷畸形的女性进行了手术。手术时，BMI 范围从 20.5 到 33.4，平均为 26.2kg/m。平均体重减轻 47.8kg，平均时间为 18 个月。
在切开并向前和向后臂皮瓣推进的过程中，保留了去上皮化的真皮脂肪瓣。根据需要对皮瓣进行修剪，以获得适当的周长，同时保持上臂的比例和轮廓平衡。
在 14 个月的随访中，所有患者均报告满意度高。客观评估基于中上臂周径（MUAC）的测量及其与中前臂周径（MFAC）的比值，与 BMI 正常的健康志愿者手臂进行比较。
在 MWL 后严重上臂瘪陷畸形的女性中，自体真皮脂肪瓣可增加上臂的丰满度，使其与前臂保持适当的平衡。这一发现得到了对 BMI 正常健康女性 MUAC/MFAC 的客观人体测量结果的支持，达到了 1.366 的平均值。正常上臂周长应等于前臂周长的 1[Formula: see text]。
证据等级 IV：本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学等级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
